action potentials at the finger. A.S. Wee and R.A. Ashley. 93. Electrophysiologic evaluation of beri-beri polyneuropathy. W. Djoenaidi and. S.L.H. Notermans. 97 ...
Electromyography and Clinical Neurophysiology Volume 30 INDICES 1990
Posterior antebrachial cutaneous ShinJoong O h
neuropathy. Case report. CheinWei Chang
and 3
Electromyography of arrow release in archery. M P . Hennessy and A . W . Parker . . . .
7
Comparison of the electrophysiological pattern of fatigue between athletes required to perform explosive and endurance sports. J.J. Vatine, A . Blank, M . Shochina, A . Swissa, Y . M a h l e r , B . G o n e n and A . M a g o r a
19
Electromyographic findings in class I I division 2 and class H I malocclusions. G . A n t o n i n i , L . C o l a n t o n i o , N . M a c r e t t i , G . L . Lenzi
27
Ulnar-to-median anastomosis and its role in the diagnosis of lesions of the median nerve at the elbow and the wrist. V . G o l o v c h i n s k y
31
Somatosensory evoked potentials from median nerve; normative data. J. Verroust, A . Blinowska, R. V i l f r i t , D . Couperie, D . Malapert, M . Perrier
35
Central motor conduction in ischaemic and hemorragic cerebral lesions. M . J . Segura, C . N . G a n d o l f o , R . E . P . Sica
41
Electrotonic potentials of myelinated nerve fibers. A . G y d i k o v , A . Kossev, N . Trayanova and D . Stephanova
47
Pseudoselectivity of the neuromuscular block in ocular myasthenia: a S F E M G study. B. E m e r y k , K . R o w i n s k a - M a r c i n s k a and T . N o w a k - M i c h a l s k a
53
Nerve conduction velocity in patients under long term treatment with antiepileptic drugs. K . - H . Krause and P. Berlit
61
Planar vector projection of short-latency median nerve somatosensory evoked potentials. G. Adler
67
Diagnostic value of extensor digitorum brevis F-wave in L 5 root compression. I . Aiello, S. Patraskakis, G . F . Sau, G . Z i r a t t u , M . Bissakou, G . Patta and S. Traccis
73
Visual and auditory evoked potentials in migraine. M . E . Drake, A . Pakalnis, S.A. Hietter and H . Padamadan
77
Median frequency estimates of paraspinal muscles: reliability analysis. H . J . Biedermann, G . L . Shanks, J. Inglis
83
Myobiofeedback in motor reeducation of wrist and fingers after hemispherial stroke. O. R a t h k o l b , St. Baykoushev and V . Baykousheva
89
Effect of interelectrode recording distance on morphology of the antidromic sensory nerve action potentials at the finger. A . S . Wee and R . A . Ashley
93
Electrophysiologic evaluation S . L . H . Notermans
97
of
beri-beri
polyneuropathy.
W.
Djoenaidi
and
———
—T
Universitats-
Mixed and sensory nerve action potentials of the median nerve in patients with peripheral neuropathy or motor neurone disease. K . Nakashima and K . Takahashi
105
Electromyographic analysis of reach in individuals with cerebral palsy. S.J. Spaulding, S.C. White, J.J. McPherson, R. Schild, C. Transon and P. Barsamian
109
Quantitative sensory thresholds in carpal tunnel syndrome. M P . M e r c h u t , M . A . Kelly and S. Cone Toleikis
119
The long loop reflex in spinocerebellar degeneration and motor neuron disease — its changes with T R H therapy. T . Touge, H . Takeuchi, A . Yamada, H . M i k i and M . Nishioka
131
The EMG-force relationships of skeletal muscle; dependence on contraction rate, and motor units control strategy. M . Solomonow, R. Baratta, H . Shoji and R. D'Ambrosia
141
Referral diagnosis versus electroneurophysiological finding. Two years electroneuromyographic consultation in a Rehabilitation Clinic. R. Danner
153
The brainstem auditory evoked potential: effects of high frequency filtering. N . A . Shaw
159
Relationship between the size of the recording electrodes and morphology of the compound muscle action potentials. A S . Wee and R . A . Ashley
165
Height, an important factor in the latency of somatosensory evoked potentials. I I N . Sunw o o , H y o K . C h o and Shin J. O h
169
Segmental hypermobility in lumbar spine and entrapment of dorsal rami. Sihvonen and Juhani Partanen
175
Teuvo
Comparison of human triceps surae H-reflexes obtained from mid and distal recording sites. M . M o r e l l i , S.J. Sullivan and D . E . Seaborne
181
Secondary evoked muscle potential mapping according to the F , H , H F , F H features of nonexistence in proximal and distal limb muscles. A preliminary communication. A . Jusic, N . Fronjek, A . Bogunovic, L j . Sragalj, R. Baraba and S. T o m i c
187
The effects of stimulus rate on the brainstem auditory evoked potential. N . A . Shaw . .
195
Reproducibility of somatosensory evoked potentials ( S E P s ) after median nerve stimulation. T . Andersson and A . Persson
205
O n the parameterization of the E M G interference pattern power spectrum ( E M G I P - P S ) . I . Y a a r and L . Niles
213
A volume conductor study of electrotonic potentials of unmyelinated excitable fibers. A . A . G y d i k o v and N . A . Trayanova
227
Electrophysiological and magnetic resonance imaging correlates of brainstem demyelinating lesions. A . U n c i n i , A . Faricelli, M . Assetta, A . Serio, A . T a r t a r o and D . G a m b i
233
Electromyographic findings in Emery-Dreifuss disease. K . Rowinska-Marcinska and I . Hausmanowa-Petrusewicz
239
Muscle vibration facilitates orderly recruitment of motor units. C.-C. M a o , K . C. M c G i l l and L . J . D o r f m a n n
245
Well preserved complex motor activities along with extreme electrophysiological pathology in patients with M . Charcot-Marie-Tooth. Study of 10 cases. A . Jusic
253
Post-contraction variations in motor pool excitability. B . R . Etnyre, T . Kinugasa and L . D. Abraham
259
Electrophysiologic signs of sensory fiber lesion in spinal amyotrophies and the role of physiologic variations of sensory finger innervation pattern. A . Jusic, I . Bosnjak and Z. Hundozi
265
Median nerve F wave conduction in healthy subjects over age sixty-five. C. Nelson, J. A . W h i t e , R. U . Mitchell and C. D . H a l l
269
Radiation-induced brachial plexopathy: clinical and electromyographical ( E M G ) considerations in 13 cases. P. F a r d i n , S. Lelli, P. Negrin and S. M a l u t a
277
Surface E M G and motor unit activity of partially denervated human muscle during fatiguing submaximal isometric contraction. C h . G i r o u x and B. M a t o n
283
Aging and quantitative sensory thresholds. M . P . M e r c h u t and S. Cone Toleikis
293
Forearm Median Nerve Conduction Velocity in Carpal Tunnel Syndrome. W . S . Pease, H . H . Lee and E.W. Johnson
299
Transmission of acoustic or vibratory signals from a contracting muscle to relatively distant tissues. A . S . Wee and R . A . Ashley
303
Refractory studies in early detection of Carpal Tunnel Syndrome. S . K . Palliyath and L . Holden
307
Technical approaches to hemisphere-selective transcranial magnetic brain stimulation. B . - U . Meyer, H . K l o t e n , T . C . B r i t t o n and R. Benecke
311
In Memoriam Prof. Dr. A . G Y D I K O V
323
Volume-conducted or "far-field" compound action potentials intrinsic-hand muscles. A . S. Wee and R. A . Ashley
originating from the 325
Electromyographic reflexes evoked in human flexor carpi radialis by tendon vibration. F . W . J . Cody, C . N . G o o d w i n and H . C . Richardson
335
Comparison of stretch reflex activities and reaction times in two separate age groups of human subjects. D . Sciarretta and P. Bawa
345
Sensory nerve conduction study in forearm segment of superficial radial nerve: standardization of technique. Chein W e i Chang and Shin Joong O h
349
Modulation of stretch activity with instruction. D . Sciarretta and P. Bawa
353
Cryptogenic hemifacial spasm. A neurophysiological study. G . R o t h , M . R . Magistris, P. Pinelli and B. Rilliet
361
Determination of peak-ratio by digital turns-amplitude analysis on line. R. L i g u o r i , K . D a h l , S. Vingtoft and A . Fuglsang-Frederiksen
371
Chronic inflammatory demyelinating polyneuropathy as first manifestation of human immunodeficiency virus infection. A . Cruz M a r t i n e z , J. Rabano, C. Villoslada and A . Cabello
379
Do joint receptors modulate the motoneuron excitability? M A . Sabbahi, A . M . F o x and C. Druffle
387
Comparisons between surface electrodes and intramuscular wire electrodes in isometric and dynamic conditions. B . G i r o u x and M . Lamontagne
397
Observations of the posterior tibial nerve S E P of patients requiring extradural spinal surgery. A . N . Guthkelch, C R . B a m f o r d , J . A . Gaines and R . B . D z i o b a
407
Quadriceps excitability is enhanced by a conditioning tap to the Achilles tendon. D . M . Koceja, G . K a m e n and J.R. Burke
415
Disintegration of the motor unit in post-polio syndrome. Part I . Electrophysiological findings in patients after poliomyelitis. B. Ryniewicz, K . Rowinska-Marcinska, B. Emeryk and I . Hausmanowa-Petrusewicz
423
Electromyographic study of the sternocleidomastoid D . Costa, M . V i t t i and D . De Oliveira Tosello
429
muscle
in head
movements.
Double pattern of relationship between skin temperature, thermoregulation and sensory nerve conduction. J. Koczocik-Przedpelska and S. G o r s k i
435
Conduction velocity along muscle fibers in situ in healthy infants. A . Cruz Martinez and J . M . Lopez Terradas
443
Disintegration of the motor unit in post-polio syndrome. Part I I . Electrophysiological findings in patients with post-polio syndrome. B. Emeryk, K . Rowinska-Marcinska, B. Ryniewicz and I . Hausmanowa-Petrusewicz
451
Discharge pattern of tonically activated motor units during unloading. L . Gerilovsky, A . Struppler, F . Velho and O. Niehage
459
Unilateral enhancement of early and late blink reflex components in hemidystonia. R. Raffaele, A . Palmeri, G . Ricca, A . Casabona and V . Perciavalle
469
Fiber density in congenital muscle fiber type disproportion. I . Congenital myopathies. K . Rowinska-Marcinska, M . H . Strugalska and I . Hausmanowa-Petrusewicz
475
The behaviour of the mean power frequency of the surface electromyogram in biceps brachii with increasing force and during fatigue. With special regard to the electrode distance. B . Gerdle, N . - E . Eriksson and L . B r u n d i n
483
Magnetic stimulation F-responses. S. G o m i n a k , D . Cros and B. Shahani
491
Aging effects on brainstem auditory evoked potentials. P. Costa, P. Benna, C. Bianco, P. Ferrero and B . Bergamasco
495
F-response assessment A. Modica
501
in healthy control subjects. B. Fierro, D . R a i m o n d o
and
Hereditary compression neuropathy. Report of a family. K . V a n den Neucker and G . Vanderstraeten
Tel. 32-10-86.67.37
509
Nerve conduction velocity in patients under long term treatment with antiepileptic drugs K . - H . Krause and P. Beritt
1
Abstract Motor and sensory nerve conduction velocity (NCV) of median nerve and motor NCV of peroneal nerve were measured in 548 epileptic patients, aged 20 to 40 years, under long term treatment with antiepileptic drugs. Compared with a control collective of 70 healthy persons in the same age the epileptics showed a reduction of all NC Vs. 19 percent of the epileptic collective had at least 1 diminished NCV. Negative correlations with total amount and average daily dose of antiepileptic drugs were found in both sexes for sensory NCV of median nerve and motor NCV of peroneal nerve, only in males also for motor NCV of median nerve. Only in females, duration of therapy correlated negative with sensory NCV of median and motor NCV of peroneal nerve. In patients under monotherapy the group with carbamazepine treatment showed the lowest NCV values, the difference being significant for motor NCV of median nerve in comparison to phenytoin and valproate sodium. It is concluded, that NCV generally is lowered under long term treatment with antiepileptic drugs and that phenytoin has no specific influence compared with the other drugs.
Introduction A negative influence of phenytoin on the function of peripheral nerves has been discussed already in 1942 (10). Meanwhile a reversible lowering of nerve conduction velocity (NCV) has been prooven in cases with acute phenytoin intoxication (1, 13, 18, 21). Concerning the possible implication of long term treatment the discussion is controverse: studies showed different results, the frequency of electrophysiological abnormalities ranging from 0 % to 89% (2, 5-9, 11, 16, 22, 24-26). Ramirez et al. described a reversible neuropathy after 30 years of phenytoin administration, characterized by axonal shrinkage and secondary demyelination in sural nerve biopsy (19). The aim of our study was: 1. to compare NCV's o f a big number of patients, treated for a long time with
Department of Neurology. University of Heidelberg, F.R.G.
Electromyogr.
ciin. NewophysioL,
1990, 30, 61-64.
several antiepileptic drugs, with those of a control collective, 2. to evaluate possible relations of NCV's with total amount and daily dose of anticonvulsants as well as with the duration of treatment, and 3. to compare the patients under monotherapy with respect to possible differences in NCV's.
Materials and methods 548 epileptics (313 males, 235 females) of the Heidelberg outpatient clinic for convulsive disorders were investigated, who took antiepileptic drugs since 1 year at least. To keep out influences of age, well-known for NCV's, only patients with an age of 20 to 40 years were considered. A further criterion for exclusion was the presence of a possible other cause of for neuropathy like diabetes mellitus, uremia or alcohol abuse. For each anticonvulsant drug taken by the patient, duration o f therapy and 61
average daily dose were fixed. The whole dose and the average daily dose of all anticonvulsants were expressed as equivalent units, 1 unit equalling 50 mg phenytoin, 30 mg phenobarbital, 125 mg primidone, 50 mg CHP-phenobarbital, 200 mg carbamazepine, 50 mg mephenytoin, 250 mg ethosuximide, 300 mg valproate sodium, 2 mg clonazepam, 300 mg mesuximide, 100 mg sultiam, or 250 mg trimethadione. NCV's were compared by Wilcoxon test with the values of 70 healthy controls of the same age group. Motor conduction velocity ( M C V ) of median and peroneal nerve was measured with a DISA 1500 E M G system using surface stimulating and recording electrodes, sensory conduction velocity (SCV) of median nerve on the forearm in antidromic technique using ring electrodes on the second digit. Skin temperature was constant at 34 °C by use of an automatic DISA skin temperature system. Results The epileptics had lower mean values of NCV's compared with the controls (table 1). 69 epileptics showed a slowering of M C V of peroneal nerve < 4 5 m/s, 21 a reduction of M C V of median nerve < 5 0 m/s and 44 a reduction of SCV of median nerve < 5 5 m/s (see Figures 1-3). Considering overlapping in some patients, 102 epileptics remained with at least 1 pathological value of N C V . Correlation with drug parameters were calculated separately for males and females, because both sexes differed in dose of medication (Krause, 1987). In both sexes, M C V of peroneal nerve and SCV of median nerve correlated negative with drug parameters, whereas only in males M C V of median nerve showed such a correlation (Table 2). The results of the patients under monotherapy with phenytoin, carbamazepine, primidone, or valproate sodium since 1 year at least are compiled in Table 3. For all NCV's the group under carbamazepine showed the lowest values, this difference being significant for M C V of median nerve in Kruskal-Wallis test (/7
